REPORT/RECOMMENDATION TO THE BOARD OF SUPERVISORS
OF THE COUNTY OF SAN BERNARDINO
AND RECORD OF ACTION
February 11, 2020
FROM
VERONICA KELLEY, Director, Department of Behavioral Health
SUBJECT
Title v
Department of Behavioral Health’s Short-Doyle/Medi-Cal Specialty Mental Health Services Published Charges
End
RECOMMENDATION(S)
Recommendation
Approve Department of Behavioral Health’s Short-Doyle/Medi-Cal specialty mental health services Published Charges effective July 1, 2019 through June 30, 2020.
(Presenter: Veronica Kelley, Director, 388-0801)
Body
COUNTY AND CHIEF EXECUTIVE OFFICER GOALS & OBJECTIVES
Operate in a Fiscally-Responsible and Business-Like Manner.
FINANCIAL IMPACT
This item does not impact Discretionary General Funding (Net County Cost). The Department of Behavioral Health’s (DBH) Published Charges apply to all Short-Doyle/Medi-Cal (SD/MC) eligible specialty mental health services and represent the allowable interim rates that DBH may claim for federal reimbursement from the California Department of Health Care Services (DHCS).
BACKGROUND INFORMATION
DHCS provides annual updates to its county interim rates and requires DBH to obtain Board of Supervisors’ (Board) approval of DBH’s Published Charges in order to receive the allowable interim reimbursement for SD/MC specialty mental health services. The proposed 2019-20 Published Charges will be uniformly applied to all insurers, patients, and Medi-Cal payers for services provided beginning July 1, 2019 and will be applied to the Medi-Cal Cost Report completed by DBH after the close of 2019-20.
In 1957, the Short-Doyle Act was passed by California legislation requiring counties to ensure the delivery of mental health services utilizing a system of county operating contract providers. Through the SD/MC expansion, expenses for certain specialty mental health services incurred by the County are eligible to receive federal reimbursement. SD/MC specialty mental health services are provided to County eligible residents by both County operated clinics and DBH contracted service providers. The SD/MC claims processing system enables California county Mental Health Plans (MHP) to obtain reimbursement from DHCS for medically necessary specialty mental health services provided to Medi-Cal eligible beneficiaries diagnosed as seriously mentally ill adults and emotionally disturbed children. Obtaining reimbursement for services provided to clients allows DBH, the MHP for the County, to continually provide necessary services.
On September 3, 2019, DHCS provided DBH with county interim rates for 2019-20, based on DBH’s 2016-17 Medi-Cal Cost Report. The proposed Published Charges for SD/MC specialty mental health services noted below are effective July 1, 2019 through June 30, 2020 and are based on the county interim rates.
|
SD/MC Specialty Mental Health Service |
2018-19 Published Charge Rates |
2019-20 DHCS Interim Rates |
2019-20 Proposed Published Charge Rates |
|
Crisis Stabilization Emergency Room Rate Per Hour |
$111.98 |
$74.24 |
$74.24 |
|
Crisis Stabilization Urgent Care Rate Per Hour |
$111.98 |
$74.24 |
$74.24 |
|
Day Treatment Intensive Services Rate Per Half Day |
$187.67 |
$193.13 |
$193.13 |
|
Day Treatment Intensive Services Rate Per Full Day |
$263.59 |
$271.26 |
$271.26 |
|
Day Treatment Rehabilitation Rate Per Half Day |
$109.48 |
$112.67 |
$112.67 |
|
Day Treatment Rehabilitation Rate Per Full Day |
$354.53 |
$175.86 |
$175.86 |
|
Case Management Rate Per Minute |
$3.53 |
$4.15 |
$4.15 |
|
Intensive Care Coordination Per Minute |
$3.53 |
$4.15 |
$4.15 |
|
Mental Health Services Rate Per Minute |
$3.60 |
$3.72 |
$3.72 |
|
Intensive Home-Based Services Per Minute |
$3.60 |
$3.72 |
$3.72 |
|
Therapeutic Behavioral Services Rate Per Minute |
$3.60 |
$3.72 |
$3.72 |
|
Medication Support Services Rate Per Minute |
$7.51 |
$7.79 |
$7.79 |
|
Crisis Intervention Services Rate Per Minute |
$8.85 |
$9.71 |
$9.71 |
|
Hospital Inpatient Day |
$1,626.09 |
$1,850.27 |
$1,462.21 |
|
Hospital Administrative Day |
$1,626.09 |
$514.95 |
$514.95 |
|
Psychiatric Health Facility |
$703.24 |
$723.66 |
$723.66 |
|
Adult Crisis Residential |
$396.57 |
$408.08 |
$408.08 |
|
Adult Residential |
$193.43 |
$199.04 |
$199.04 |
The proposed 2019-20 Hospital Day Rate has been adjusted to reflect the actual cost and utilizes the published interim rate from the state 2015-16 that was closest to the most recent cost settlement. This change does not impact DBH’s services or activities.
This item is being presented at this time as this is the first Board date available for presentation following the extensive research and required operational, fiscal, and administrative reviews. Approval of the proposed Published Charges after the effective date of July 1, 2019 will have no impact on DBH’s services or activities.
PROCUREMENT
N/A
REVIEW BY OTHERS
This item has been reviewed by Behavioral Health Contracts (Natalie Kessee, Contracts Manager, 388-0869) on January 9, 2020; County Counsel (Dawn Martin, Deputy County Counsel, 387-5455) on January 17, 2020; Finance (Christopher Lange, Administrative Analyst, 386-8393) on January 24, 2020; and County Finance and Administration (Tanya Bratton, Deputy Executive Officer, 388-0332) on January 24, 2020.